急性肠系膜上动脉缺血37例诊治转归  

Experience in the management of acute superior mesenteric artery ischemia

作　　者：王雷[1] 辛世杰[1] 张健[1] 张曦彤[2] 杨栋[1] 张赞松[1] 段志泉[1] 

机构地区：[1]中国医科大学附属第一医院普通外科教研室血管与甲状腺外科,沈阳110001 [2]中国医科大学附属第一医院介入科,沈阳110001

出　　处：《中华外科杂志》2008年第11期816-819,共4页Chinese Journal of Surgery

摘　　要：目的探讨急性肠系膜上动脉缺血的诊治方法，提高诊治水平。方法回顾分析1996年1月至2007年8月收治的37例急性肠系膜上动脉缺血患者的临床资料，结合文献讨论其病因、诊断及治疗。结果急性肠系膜上动脉栓塞19例（51．4％），急性肠系膜上动脉血栓形成15例（40．5％），孤立的肠系膜上动脉夹层2例（5．4％），肠系膜上动脉瘤1例（2．7％）。急诊误诊19例（51．4％）。院内死亡18例（48．6％），多死于重症感染和多器官功能衰竭。存活的19例中3例遗留严重后遗症（短肠综合征2例，脑出血1例）。共9例患者获得随访，平均随访15个月，其间5例死亡。结论急性肠系膜上动脉缺血病因多样，早期干预可显著改善患者预后。Objective To study the management of acute superior mesenteric artery （SMA） ischemia and to improve its prognosis. Method The clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed. Results Of the cases, 19 （51.4% ） patients were diagnosed with acute SMA embolism, 15 （40.5%） with acute SMA thrombosis, 2 （5.4%） with spontaneous isolated dissection of SMA and 1 （2.7%） with SMA aneurysm. Nineteen （51.4%） patients were misdiagnosed in emergency. Eighteen （48.6%） patients died in the hospital, and most of them died of severe infection and multiple organ failure. Three cases of the survived 19 patients experienced severe complications （2 with short gut syndrome, 1 with cerebral hemorrhage）. Nine cases were followed-up for a mean period of 15 months, and 5 died during that term. Conclusions Acute SMA ischemia has multiple etiological factors. Early intervention can improve the prognosis.

关 键 词：肠系膜上动脉 动脉栓塞 血栓形成 缺血 

分 类 号：R686[医药卫生—骨科学]